Abstract

Ice is commonly used after acute muscle strains but there are no clinical studies of its effectiveness. By comparison, there
are a number of basic scientific studies on animals which show that applying ice after muscle injury has a consistent effect
on a number of important cellular and physiological events relating to recovery. Some of these effects may be temperature
dependant; most animal studies induce significant reductions in muscle temperature at the injury site. The aim of this short
report was to consider the cooling magnitudes likely in human models of muscle injury and to discuss its relevance to the
clinical setting. Current best evidence shows that muscle temperature reductions in humans are moderate in comparison to most
animal models, limiting direct translation to the clinical setting. Further important clinical questions arise when we consider
the heterogenous nature of muscle injury in terms of injury type, depth and insulating adipose thickness. Contrary to current
practice, it is unlikely that a ‘panacea’ cooling dose or duration exists in the clinical setting. Clinicians should consider
that in extreme circumstances of muscle strain (eg, deep injury with high levels of adipose thickness around the injury site),
the clinical effectiveness of cooling may be significantly reduced.